Longer lifetime exposure to ovarian estrogens may protect against noncardioembolic ischemic stroke. However, a very early age of exposure onset could be disadvantageous.

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Background and Purpose: Acute and chronic infections may play a role in promoting complications of atherosclerotic disease. We evaluated the importance of acute infections and chronic bronchitis (CB; as a chronic inflammatory state) in several subtypes of ischemic stroke, and we investigated whether the influenza vaccination was independently associated with a reduced likelihood of stroke. Methods: A case-control study was performed on 393 consecutive ischemic stroke patients and 393 control subjects matched for age, sex and time of year. Data were collected by a structured interview that assessed risk factors, acute infections within the preceding 2 months, CB and whether they had received the influenza vaccination. Results: Infections within the 2 months before stroke onset and CB were more common among patients than control subjects [23.3 vs. 16.3% (p = 0.014) and 17.2 vs. 8.5% (p = 0.001), respectively]. After adjustment for traditional risk factors, the risk of stroke was increased in the subjects with CB (OR = 1.83, 95% CI = 1.35–2.48, p = 0.016), but not with acute infection (OR = 1.32, 95% CI = 0.98–1.78, p = 0.16). Acute infections and CB increased the risk of ischemic events in all age groups; this reached significance for patients older than 60 years. The profile of vascular risk factors was similar in patients with and without previous infections. The influenza vaccination did not prevent ischemic stroke, and it did not reduce the rate of acute previous infections in stroke patients. Conclusions: CB and infections over the previous 2 months predicted the risk of ischemic stroke. The influenza vaccination was not associated with a reduction in the incidence of stroke in our group of patients.

Introduction: Stroke is a potentially disabling event, therefore determining its etiology is the key in the development of management strategies to reduce the risk of a new event and costs. Obstructive sleep apnea (OSA) is common in stroke and is an independent risk factor. The objective of this study was to determine the association between the etiology of ischemic stroke and the presence of OSA. Methods: Observational, descriptive, patients with ischemic stroke or acute transient ischemic attack (TIA) in the Hospital Memorial São José and Hospital Esperança Recife-PE for one year, the etiology of stroke was categorized by TOAST classification and portable polysomnography for diagnosis of OSA. Results: 100 patients analyzed, 81 ischemic strokes and 19 TIA. The prevalence OSA (AHI≥15) was 51%. The mean age of the sample was 67.9±14.6 years, with older OSA patients (70.0±14.2 vs 65.6±14.7, p=0.128). There was a higher occurrence of females, DM, dyslipidemia and previous ictus in patients with OSA (p=0.052 /0.008 /0.055 /0.018, respectively). BMI was 27.22±4.3kg/m² in patients without OSA and 28.05±3.8kg/m² among patients with OSA. There was no association between the etiological subtype of ictus and the presence of OSA (p=0.698). Conclusions: Our study included an elderly population with a higher frequency of dyslipidemia, DM and previous ictus in patients with OSA, but it was not possible to establish a relationship between the etiology of the stroke and the presence of OSA.